Glute Tendon Pain (Gluteal Tendinopathy): Symptoms, Causes & PT Treatment
Updated October 20261 minute read
Gluteal tendinopathy is irritation and overload of the gluteal tendons where they attach to the outer hip — the most common cause of persistent outer-hip pain, especially in women in midlife. It hurts on the side of the hip, often worse lying on that side, climbing stairs, or after standing on one leg. The proven treatment is progressive strengthening plus load management, not rest or repeated injections.
What is gluteal tendinopathy?
It's an overload condition of the gluteus medius and minimus tendons at the outer hip. It's the main driver of "greater trochanteric pain syndrome" and is often mislabeled as simple bursitis.
Symptoms
Common features are outer-hip pain and tenderness, worse lying on that side at night, with stairs, single-leg standing, or after walking. Pain can spread down the outer thigh.
What causes it / risk factors
A sudden increase in load, weak hip muscles, and compressive positions (sitting cross-legged, "hanging" on one hip, prolonged side-lying) contribute. It's more common in women around menopause.
How it's diagnosed
Diagnosis is clinical from the location and aggravating positions, sometimes supported by imaging in unclear cases.
Physical therapy treatment
What a PT does. Your therapist removes compressive positions and progressively loads the gluteal tendons to restore capacity. Exercises & progression (overview). Progressive gluteal strengthening, avoiding tendon-compressing positions, and graded return to activity. Education plus exercise outperforms injection alone over time. Recovery timeline. Often several weeks to a few months; tendons respond slowly but reliably.
Treatment options compared
Education and progressive loading are first-line. Injections may relieve pain short-term but don't build the needed strength.
Red flags
A hot, swollen hip with fever needs urgent care. Inability to bear weight after a fall warrants prompt evaluation.
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Frequently asked questions
Side-lying compresses the irritated tendons against the bone.
Sources (6)
- Mellor R, et al. Education plus exercise versus corticosteroid injection use versus a wait and see approach on global outcome and pain from gluteal tendinopathy (LEAP trial). BMJ. 2018. — PubMed
- Grimaldi A, Fearon A. Gluteal Tendinopathy: Integrating Pathomechanics and Clinical Features in Its Management. J Orthop Sports Phys Ther. 2015. — PubMed
- AAOS OrthoInfo: Hip Bursitis. — AAOS OrthoInfo
- Bremer T, et al. The efficacy of gluteal tendinopathy treatments: a systematic review. Clin Rehabil. 2025. — PubMed
- Ganderton C, et al. Gluteal loading versus sham exercises to improve pain and dysfunction in postmenopausal women with greater trochanteric pain syndrome: a randomized controlled trial. J Womens Health. 2018. — PubMed
- ChoosePT (APTA): Physical Therapy Guide to Greater Trochanteric Bursitis. — ChoosePT
This article is for education only and isn't medical advice. Always talk to a licensed clinician about your specific situation.